Robotic UV plasty is becoming more and more popular to treat bladder neck contracture (BNC) and vesico urethral anastomotic stricture (VUAS) in male patients. While the procedure has several similar principles for both indications, vesico-urethral anastomotic stricture may be more challenging to treat due to its location below the pubic bone. Most of the existing series have reported the outcomes of these two procedures altogether. The aim of the present study was to compare the outcomes of robotic YV plasty for BNC vs. VUAS.

Data from all patients who had robotic YV plasty for BNC after endoscopic treatment of benign prostatic hyperplasia or VUAS were retrospectively collected between August 2019 and november 2021. This treatment option was offered to symptomatic patients with multiple endoscopic treatment failures. For anastomotic stricture, we used a combined approach (perineal+ robotic abdominal) whenever deemed necessary to mobilize the bulbar urethra and ensure tension-free anastomosis.

Sixteen patients were included in the study : 4 in the VUAS group and 12 in the BNC group. The results are presented in Table 1. The mean age was 70.5 years. All patients had at least one prior endoscopic procedure. The median operative time was 336.2 and 154.6 minutes (p=0.004) with a mean bleeding of 137.5 and 50.8 mL (p=0.04) in the VUAS and BNC groups, respectively. There were two (50%) and four (25%) minor Clavien-Dindo complications in the two groups (NS). No major postoperative complication occurred. All patients in the VUAS group were much or very much improved according PGII score, compared to 80% of BNC patients. Patency rate is 100% and 92.7% (1 recurrence) in both groups (NS).

Sixteen patients were included in the study : 4 in the VUAS group and 12 in the BNC group. The results are presented in Table 1. The mean age was 70.5 years. All patients had at least one prior endoscopic procedure. The median operative time was 336.2 and 154.6 minutes (p=0.004) with a mean bleeding of 137.5 and 50.8 mL (p=0.04) in the VUAS and BNC groups, respectively. There were two (50%) and four (25%) minor Clavien-Dindo complications in the two groups (NS). No major postoperative complication occurred. All patients in the VUAS group were much or very much improved according PGII score, compared to 80% of BNC patients. Patency rate is 100% and 92.7% (1 recurrence) in both groups (NS).

Robotic YV plasty appears to be equally effective for both bladder neck and vesico-urethral anastomotic stricture but is more technically challenging with less favorable perioperative outcomes when performed for anastomotic stricture.